Note: This material is based on resources from Department of Veterans Affairs–Post-Deployment Health Services/War Related Illness and Injury Study Center and use of facilities from Veterans Affairs New Jersey Health Care System in East Orange, New Jersey.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government.

Background: Recent epidemiologic studies have reported an increased risk for respiratory conditions in service members deployed to Iraq or Afghanistan (1) since 2001 and an increasing prevalence of chronic lung disease in this population (2). Reports of dyspnea and exercise intolerance have mostly been attributed to exposure to airborne hazards, such as burn-pit smoke and particulate matter.

Exposure to blast waves during military deployment has been recognized as the hallmark injury of the wars in Iraq and Afghanistan, and considerable efforts have been made to understand the associated neurologic sequelae. However, less attention has been paid to the lungs, which may be particularly susceptible to blast waves given tissue-density gradients. The exact relationship between blast lung injury and long-term sequelae is unknown; however, animal models show long-term, persistent elevations in oxidative stress and vascular abnormalities after blast exposure (3), which may contribute to respiratory symptoms. Associations between blast exposure and chronic lung diseases in this cohort have recently been suggested (2).